Craniocerebral epidermoids and dermoids

Abstract

We review 40 epidermoids and 4 dermoids of the skull and brain treated surgically in our Department between 1976 and 1987. Fourteen were extradural and 30 intradural. The mean duration of symptoms was 3 years for extradural and 10 years for intradural tumours. Symptoms varied with tumour site, in some sites being helpful in differential diagnosis. Skull X-rays and CT were the key diagnostic investigations in extradural and CT in intradural lesions, the latter, with few exceptions, presenting a characteristic CT scan. In 7 cases MRI supplied important details on the tumour boundaries. All the diploic and orbital lesions were removed totally, with a good outcome. Twelve of the intradural lesions were removed totally, 9 subtotally and 9 partially, with a good outcome in 21 patients and a poor outcome in 4; 5 patients died. Outcome was unrelated to degree of removal.

Intracranial dermoid cysts: variations of radiological and clinical features

“…Intracranial dermoids are rare congenital conditions that account for 0.04-0.6% of all intracranial tumours [18,33]. Derived from ectopic cell remnants that are incorporated into the neural tube, they are usually located along the midline.…”

“…Various clinical aspects such as presentation with epileptic seizures, meningitis, focal neurological deficits, hydrocephalus, sudden death and incidental diagnosis have been reported. These acute symptoms associated with the presence of dermoids, their localisation and their rupture are well documented [1,2,5,14,15,17,18,20,23,26,33,[40][41][42]. Diagnostic findings were evaluated in the past but Gd Gadolineum, N/a not available, HCP hydrocephalus, n/v nausea/vomiting, DWI diffusion weighted imaging show strong individual variation [4,8,9,13,22,24,27,31,32,36,38,44,45].…”

Reversible Bilateral Vestibular Impairment Caused by Fourth Ventricle Epidermoid Tumor-Case Report-

“…1,21) Epidermoid tumors of the fourth ventricle account for between 5% and 31.4% of all intracranial epidermoid tumors. 7,9,13,15,16,19,20) The clinical symptoms vary depending on the location, extension, and degree of adhesion to vital structures. Headache, 3,11) gait ataxia, 3,9,13,20) and vertigo 6,14) are common initial symptoms of epidermoid tumors of the fourth ventricle.…”

Skull Base Dermoid Cyst in the Right Infratemporal Fossa Diagnosed Using the Dixon Technique: a Case Report and Review of Literature

“…For imaging the diagnosis of dermoid cysts, MRI is demonstrated to be superior to CT, as it provides high signal intensity of the lesion on T1-weighted images and variable signal intensity on T2-weighted images. The signal intensity of MR images can be significantly influenced by fat content, calcification, hair follicles, epithelial debris, sebum, and water content within dermoid cysts (7,8). Absence of perilesional edema and the presence of well-defined margins with characteristic signal intensity on MR images are helpful in differentiating dermoid cysts from other benign, space-occupying lesions, such as cystic neoplasms, arachnoid cysts and epidermoid cysts.…”